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An infant is experiencing dyspnea related to patent ductus arteriosus (PDA). What does the nurse understand regarding why dyspnea occurs?
- A. Blood is circulated through the lungs again, causing pulmonary circulatory congestion.
- B. Blood is shunted past the pulmonary circulation, causing pulmonary hypoxia.
- C. Blood is shunted past cardiac arteries, causing myocardial hypoxia.
- D. Blood is circulated through the ductus from the pulmonary artery to the aorta, bypassing the left side of the heart.
Correct Answer: A
Rationale: When PDA is present, oxygenated blood recycles through the lungs, overburdening the pulmonary circulation.
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A nurse assesses an older adult client who has multiple chronic diseases. The client’s heart rate is 48 beats/min. Which action should the nurse take first?
- A. Document the finding in the chart.
- B. Initiate external pacing.
- C. Assess the client’s medications.
- D. Administer 1 mg of atropine.
Correct Answer: C
Rationale: A heart rate of 48 beats/min (bradycardia) in an older adult with multiple chronic diseases may be due to medication side effects. Assessing the client’s medications is the first step to determine if any drugs are contributing to the bradycardia.
Regarding ECG in infancy
- A. T Wave inversion present
- B. PR interval is < 0.16 s
- C. P wave is < 3mm tall
- D. QRS represent ventricular depolarization
Correct Answer: B
Rationale: In infants, the PR interval is shorter than in adults (< 0.16 seconds).
Ten hours following thrombolysis for an ST elevation myocardial infarction (STEMI), a client is receiving a lidocaine infusion for isolated runs of ventricular tachycardia (VT). Which finding should the nurse document in the electronic medical record as a therapeutic response to the lidocaine infusion?
- A. Stabilization of blood pressure ranges
- B. Cessation of chest pain
- C. Reduce heart rate
- D. Decreased frequency of episodes of VT
Correct Answer: D
Rationale: Lidocaine is used to suppress ventricular tachycardia, so a decrease in episodes indicates a therapeutic response.
Increased anion gap is seen in:
- A. Uraemia
- B. Starvation
- C. Renal tubular acidosis
- D. Acetazolamide therapy
Correct Answer: A
Rationale: Uraemia, a condition of high levels of urea in the blood, is associated with an increased anion gap due to the accumulation of acids.
All are true about genotype - phenotype correlation in Brugada syndrome, except
- A. SCN5A mutation is associated with short PR interval
- B. LTCC mutation is associated with short QT interval
- C. Yield of genetic testing is low (25%)
- D. No major therapeutic implication of genetic testing
Correct Answer: D
Rationale: There are therapeutic implications of genetic testing in Brugada syndrome.